The University of Mississippi Medical Center proposes to continue its participation as a Clinical Center in NIDDK's Gastroparesis Clinical Research Consortium. Our study team, headed by Thomas Abell, MD, a recognized expert in research and clinical experience in the area of gastroparesis, will now include as co- investigator Michael Griswold, PhD, an expert in biostatistics, and as collaborator Filip To, PhD, an expert in data automation, signal analysis, data fusion, and instrumentation, along with key members of our initial research team and two UMC collaborators from Surgery and Pathology, respectively. The multidisciplinary expertise provided by this team will further our ability to investigate the complex pathophysiological pathways and symptoms associated with gastroparesis. The UMMC Vice Chancellor for Health Affairs and the Associate Vice Chancellor for Research continue to provide strong support for and the resources necessary to conducting the Clinical Center's research. With respect to Consortium-wide contributions, UMMC is well positioned to increase the study population already enrolled in the Gastroparesis Registry through its Clinical Center. Approximately 1000 patients with gastroparesis annually seek their treatment at this site;over the past 5 years, we have evaluated new patients for the disorder, identifying on the average 300 new patients with gastroparesis each year. In addition to furthering Consortium-wide protocols, two new-efforts have been proposed for the present funding period at UMMC. The first is to assess and compare associations between presenting Gl symptoms, histological counts of interstitial cells of Cajal, and electrophysiology measures for patients with GP of diabetic and idiopathic etiology, as well as to compare ICC counts in these biopsy specimens with counts in gastric tissue specimens from controls. The second is to demonstrate that Gastric Electrical Stimulation (GES) can reduce Gl symptoms by at least 50% for individual patients, to assess the impact of temporary GES on gastric emptying times, EGG values, neuro-hormonal and autonomic status markers, and HRQOL measures, and to evaluate EGG values at varied GES energy levels in predicting likely usefulness with GES. PUBLIC HEALTH RELEVANCE: In 2004, over 10,000 patients were hospitalized in the U.S. with gastroparesis, a devastating disease mainly seen in younger women, as a primary diagnosis;for 134,000 further patients it was a secondary diagnosis. We propose to continue and extend the systematic, concerted approaches developed under initial funding to maintain and analyze long-term data, so as to determine reliable treatments that decrease the toll of GP.